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Focus on girls in Sierra Leone amid Ebola

Chernor Bah, a global youth advocate and education activist from Sierra Leone, recently returned from a visit to his home country. He discussed his findings with Judith Bruce.

Judith Bruce is a policy analyst at the Population Council, whose work helps build the health, social and cognitive assets of girls in the poorest communities in the developing world. Bah was one of the founders of the Sierra Leone Adolescent Girls Network, designed to reach vulnerable girls throughout the country.

Bruce: You have recently returned from Sierra Leone. In the course of your visit you focused on the impact on girls, and you also met with political leaders and those who control important policy decisions related to the national response to Ebola. How did you explain to them that we should also be focusing on girls at this time?

Bah: Here’s why we should be focusing on girls at this time: Dorcas is 17 years old. Her mom contracted Ebola when treating a patient in the clinic where she was a nurse. Dorcas took care of her mom when she was sick at home. Her dad, her elder sister and her mom were all infected and admitted. At the hospital, after her mom and elder sister died, Dorcas was helping to take care of her dad – even in the ward where they were both sick. Her father eventually died. Dorcas survived. She is left with her two younger siblings, who have become her primary responsibility. She is now the breadwinner and without support might be forced to engage in risky behaviors to fend for herself and her family. She is also unsure of returning to school, as there is no one to take care of her or pay her [tuition] fees.

Unfortunately, her story is not unique. Many of the 30-plus girl survivors of Ebola told me varying versions of a similar story. Girls in Sierra Leone are typically the primary caregivers in the home and in the community, especially for sick relatives.

Despite being primary caregivers, girls typically have less education and even lesser access to scientifically based information. And, despite carrying provisioning responsibility, they have less access to public services.

When emergency distributions are done in communities … girls, who bear the biggest burden, are the last to get anything.

If we don’t begin with the girls, we won’t get to them.

Bruce: We hear that there is a 70 percent mortality rate, but that also means 30 percent survive. How are female survivors being treated?

Bah: Girls who have survived Ebola are super girls. They are celebrated publicly for defeating the virus, but in their communities they have less social capital. They are stigmatized and have fewer friends; they might have lost parents, loved ones or benefactors, and have very little – if any – help from the government.

Fortunately, we mostly know who they are. If they have survived Ebola, it means they have been in a health clinic, where their data was recorded. Figuring out a way of first creating a support system for these girls will be crucial. Connecting them with each other in potential Ebola survivors’ clubs could be one way. It would provide social assets and capital, provide platforms to share their stories and support. They could also be powerful role models for girls, in a society where those are few and far between.

Bruce: Before Ebola, there was already a long-standing culture of sexual exploitation; that is, some girls depended on sexual exchange for basic necessities for themselves and their families. What is the situation now?

Bah: Every girl I spoke to expressed concerns about the increase in transactional sexual exploitation. In fact, girls in Port Loko, north of the country, which has been badly hit by the virus and is now under quarantine, told me that they have friends who are now pregnant and will never return to school. We have received reports of police officers – assigned to enforce the quarantine of households – sexually molesting young females. Bear in mind that typically during school holidays, when girls are at home, there is normally a spike in sexual abuse and exploitation and early marriage. Now you have communities that are shut down or economically depressed, men and young girls are home all day and no one knows when it’s all going to end. As one girl put it to me, it’s not a very safe time to be a girl.

Bruce: We’ve heard that many of the groups originally working on programs for girls have left the country or shut down their operations. Is that true?

Bah: Amid the shock of the epidemic, the government and the donors basically instructed that all programs that were not directly dealing with Ebola be shut down, and that funds all be redirected to fighting the epidemic. So these groups have, for the most part, been on the sidelines, watching helplessly as they see girls falling further behind. I worked with UNFPA (the United Nations Population Fund) to pull together a major meeting with the members of the network, and the first thing I should say was the sense of relief and excitement that they could come together to discuss how the virus was affecting girls and their programs. They were disappointed that their programs have generally been shut down, and many have been told they can’t proceed with their normal activities, including community outreach and other alternative social safety-net programs that they say are critical for the poorest girls they serve.

Some fear a spike in sexual violence and the exploitation of young girls, an increase in teenage pregnancy and forced marriages, an increase in fistula, an increase in maternal mortality and, of course, more girls will drop out of school permanently during this long, unprecedented break in education.

Bruce: How has the emergency affected policies and programs designed to reach girls and young women?

Bah: One of the critical challenges we often face in Sierra Leone is the invisibility of girls in national policies and programs. Youth programs, government policy and interventions – under normal circumstances – typically exclude girls. It gets worse in an emergency. As the president of the country told me in a private conversation, the government was shocked and overwhelmed by this epidemic, and has been playing catch-up ever since.

While in Sierra Leone I was able to review the Reproductive Health Strategy that was being proposed by the government and its partners to respond to the sharp decline in the availability of reproductive services during the outbreak. In some cases, there had been up to a 100 percent drop in the provision of basic contraceptive services for women and girls. The core concept of the strategy was to be the creation of 17 dedicated Reproductive Health Service Centers in each of the districts across the country, but it barely referenced the unique needs of girls or had mechanisms to foster their use of these services. Thankfully, working with the partners, especially UNFPA, we were able to review the proposal to include a stand-alone adolescent girls pillar. This will increase girls’ access to these services.

One year ago, she died from complications in childbirth, a killer that every month takes twice as many lives as the entire Ebola epidemic. ... Many of these success stories were made possible through international development aid for maternal health, which increased steadily from 2010 to 2015.

Widow of Ebola Victim, Mother of Five Cries For Assistance March 18, 2018

Her story is probably more mind grappling than some of the famous stories told about the ugly impact left behind by the world's worst deadly Ebola virus outbreak in West Africa, including Liberia in 2014. Liberia became the worst affected with more than 5000 deaths. For Shianeh, every year Decoration ...

One year ago, she died from complications in childbirth, a killer that every month takes twice as many lives as the entire Ebola epidemic. ... Many of these success stories were made possible through international development aid for maternal health, which increased steadily from 2010 to 2015.

Widow of Ebola Victim, Mother of Five Cries For Assistance March 18, 2018

Her story is probably more mind grappling than some of the famous stories told about the ugly impact left behind by the world's worst deadly Ebola virus outbreak in West Africa, including Liberia in 2014. Liberia became the worst affected with more than 5000 deaths. For Shianeh, every year Decoration ...